核素肾动态显像对肾积水不显影的肾功能评估

张杰; 姚颐; 谭大清; 陈辉霖; 谢梅; 李强; 吕胜启

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核素肾动态显像对肾积水不显影的肾功能评估

首发时间：2008-06-18

张杰 ¹ 姚颐 ¹ 谭大清 ² 陈辉霖 ³ 谢梅 ³ 李强 ¹ 吕胜启 ¹

1、武汉大学人民医院泌尿外科
2、湖北民族学院附属医院泌尿外科
3、武汉大学人民医院放射科

摘要：目的探讨99m锝-二乙三胺五醋酸（99Tcm-DTPA）肾动态显像技术对一侧肾积水静脉尿路造影（IVU）不显影的肾功能评估价值及意义。方法收集48例一侧梗阻性肾积水IVU不显影、对侧肾正常的患者，患侧肾行造瘘引流术，用99Tcm-DTPA肾动态显像诊断患肾在积水减压前后的功能状态，卡方检验比较两次结果的正确率，并分析肾功能与24h引流量之间的相关性。结果肾动态显像显示48例患肾中，造瘘前仅13例（27%）有功能，患侧肾小球滤过率（GFR）平均为（46.8±5.5）ml/min，35例无功能（73%）， GFR为（16.7±5.1）ml/min；造瘘后显示19例有功能（40%）， GFR平均为（57.0±8.4）ml/min，29例无功能（60%）， GFR为（17.0±5.4）ml/min。肾脏有功能组19例患者行保肾手术后6~12个月复查99Tcm-DTPA肾动态显像显示患肾功能继续明显恢复。结论 99Tcm-DTPA肾动态显像评价肾功能的准确率明显高于IVU；但在重度积水的高张状态下99Tcm-DTPA肾动态显像仍不能完全反映肾功能，只有在肾穿刺造瘘减压1~2周后才能逐步反映其客观功能状态。

关键词：肾动态显像静脉尿路造影肾小球滤过率肾积水

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99Tcm-DTPA dynamic renal imaging for the evaluation of renal function of hydronephrosis kidney with no image on intravenous urography and its significance

Zhang Jie ¹ Yao Yi ¹ Tan Daqing ² Chen Huilin ³ Xie Mei ³ Li Qiang ¹ Lv Shengqi ¹

1、Department of urology, Renmin Hospital of Wuhan University
2、Hubei institute nationalities
3、Renmin Hospital of Wuhan University

Abstract：Objective To investigate the significance of 99Tcm-DTPA dynamic renal imaging in evaluating the renal function of obstructively hydronephrotic kidney with no image on intravenous urography (IVU). Methods A total of 48 patients with chronic severely obstructive hydronephrosis that had no image on IVU were enrolled in this study. All of them were undergone 99Tcm-DTPA dynamic renal imaging to evaluate the function of the sick kidney, and the data was divided in functioning group and non-functioning group. Following that percutaneous renal punctures were employed and 24-h drainage flow was collected. 1-2 weeks later the renal functions were evaluated by 99Tcm-DTPA dynamic renal imaging again and were compared with the diagnosis of 24-h drainage flow by chi square test. Results Before treating the hydronephrosis with percutaneous puncture, 99Tcm-DTPA dynamic renal imaging indicted that 27%(13/48) of the total 48 sick kidney were available, the glomerular filtration rate (GFR) was (46.8±5.5)ml/min, but the GFR of the rest was (16.7±5.1)ml/min. After percutaneous renal puncture, 40% (19/48) were available, all of them improved their GFR to (56.1±5.3)ml/min and the other 60% (29/32) were still unavailable, GFR remained at (17.0±5.4)ml/min. correlation analysis indicated that there exist correlation (r=0.34, P<0.05) between 24-h drainage volume and GFR after the renal obstructions were removed. The 13 functional kidneys were treated with conservative operation, and 99Tcm-DTPA dynamic renal imaging 6 months-1 year later suggested that they were all recovered in different degrees. Conclusions 99Tcm-DTPA dynamic renal imaging should be used to evaluate the function of obstructively hydronephrotic kidney when there was no image on IVU, and this technique would be more trustworthy after percutaneous puncture for 1-2 weeks.

Keywords： Dynamic renal imaging Intravenous urography Glomerular filtration rate Hydronephrosis

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1. 高等学校博士学科点专项科研基金资助项目（20060486054）

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张杰，姚颐，谭大清，等. 核素肾动态显像对肾积水不显影的肾功能评估[EB/OL]. 北京：中国科技论文在线 [2008-06-18]. https://www.paper.edu.cn/releasepaper/content/200806-440.

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论文编号	200806-440
论文题目	核素肾动态显像对肾积水不显影的肾功能评估
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